About the position The ENT Office Pro Fee Coder must be proficient in Evaluation & Management & in office Scopes for ENT cases. The coder will review clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD-10 Diagnosis codes, along with CPT/HCPCS codes as defined for the service type, for coding, billing, internal and external reporting, research as required, and regulatory compliance. Under the direction of the coding manager—the coder should accurately code conditions and procedures as documented and in accordance with ICD-10-CM Official Guidelines for Coding and Reporting, CMS/MAC rules and the CPT rules established by the AMA, and any other official coding guidelines established for use with mandated standard code sets. The coder scope may involve reviewing coding related denials from payers and recommending the appropriate action to resolve the claim based on payer guidelines. This position is 100% remote. Maintain a working knowledge of ICD-10 and CPT coding principles, governmental regulations, official coding guidelines, and third-party requirements regarding documentation and billing. Assure that all services documented in the patient’s chart are coded with appropriate ICD-10 and CPT codes. When services/diagnoses are not documented appropriately, seeks to attain proper documentation in a timely manner according to facility standards. Achieve and maintain 95% accuracy in coding while maintaining a high level of productivity. Accuracy will be monitored during monthly reviews. Maintain average productivity standards as follows Work the review queue daily to ensure all charts that are placed in the review queue are worked and any corrections are communicated to the facility if necessary. Correct and communicate charts that require re-bills to the facility daily for the re-bill process. See re-bill policy in facility guidelines. Coder downtime must be reported immediately to the administrative staff to ensure turnaround is met. Work directly with the IQC staff to ensure quality standards are being met for each facility. Provide accurate answers to physician’s/hospitals coding and/or billing questions within eight hours of request. Responsible for coding or pending every chart placed in their queue within 24 hours. Notify administrative staff in the event they cannot meet the twenty-four hour turn around standard. Coders are responsible for checking the Guidehouse email system at least every two hours during coding session. Maintain their current professional credentials while working for Guidehouse. Coders are responsible for becoming familiar with the Guidehouse coding website and using the information contained in the website as a daily tool to correctly code and abstract for each facility. Maintain HIPAA compliant workstations (reference HIPAA workstation policy) Review and adhere to the coding division policy and procedure manual content. Work with other members of the facilities coding and billing team to insure maximum efficiency and reimbursement for properly documented services. Communicate problems or coding principal discrepancies to their supervisor immediately.

Responsibilities

• Maintain a working knowledge of ICD-10 and CPT coding principles, governmental regulations, official coding guidelines, and third-party requirements regarding documentation and billing.
• Assure that all services documented in the patient’s chart are coded with appropriate ICD-10 and CPT codes.
• When services/diagnoses are not documented appropriately, seeks to attain proper documentation in a timely manner according to facility standards.
• Achieve and maintain 95% accuracy in coding while maintaining a high level of productivity.
• Work the review queue daily to ensure all charts that are placed in the review queue are worked and any corrections are communicated to the facility if necessary.
• Correct and communicate charts that require re-bills to the facility daily for the re-bill process.
• Coder downtime must be reported immediately to the administrative staff to ensure turnaround is met.
• Work directly with the IQC staff to ensure quality standards are being met for each facility.
• Provide accurate answers to physician’s/hospitals coding and/or billing questions within eight hours of request.
• Responsible for coding or pending every chart placed in their queue within 24 hours.
• Notify administrative staff in the event they cannot meet the twenty-four hour turn around standard.
• Coders are responsible for checking the Guidehouse email system at least every two hours during coding session.
• Maintain their current professional credentials while working for Guidehouse.
• Coders are responsible for becoming familiar with the Guidehouse coding website and using the information contained in the website as a daily tool to correctly code and abstract for each facility.
• Maintain HIPAA compliant workstations (reference HIPAA workstation policy)
• Review and adhere to the coding division policy and procedure manual content.
• Work with other members of the facilities coding and billing team to insure maximum efficiency and reimbursement for properly documented services.
• Communicate problems or coding principal discrepancies to their supervisor immediately.

Requirements

• High School Diploma
• Minimum 3-5 years Physician Coding experience, both IP and OP coding for physician claims
• 3 or more years coding ENT Evaluation & Management, including teaching physicians, in office scopes and office encounters occurring within the global period of a surgical procedure.
• CPC certification from AAPC
• EMR experience
• Must maintain credential throughout employment
• Must be able to work independently, multi-task well and interface with all levels of personnel as well as clients
• Excellent verbal, written and interpersonal communication skills
• High level of accuracy
• Strong Working Knowledge & experience with Federal & State Coding regulations and Guidelines

Nice-to-haves

• Epic experience

Benefits

• Medical, Rx, Dental & Vision Insurance
• Personal and Family Sick Time & Company Paid Holidays
• Position may be eligible for a discretionary variable incentive bonus
• Parental Leave
• 401(k) Retirement Plan
• Basic Life & Supplemental Life
• Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
• Short-Term & Long-Term Disability
• Tuition Reimbursement, Personal Development & Learning Opportunities
• Skills Development & Certifications
• Employee Referral Program
• Corporate Sponsored Events & Community Outreach
• Emergency Back-Up Childcare Program